Primary Motility  Disorders of the  Esophagus
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OESO©2011
 
Volume: Primary Motility Disorders of the Esophagus
Chapter: Pseudoanginal pains of esophageal origin
 

Odynophagia is less of a problem, as there is a clear relation between pain and swallowing

J. Janssens, G. Vantrappen (Leuven)

Odynophagia can be defined as a painful sensation in the esophageal region that occurs in relation to swallowing. In the majority of patients Odynophagia occurs as a consequence of esophageal mucosal lesions. Patients with peptic esophagitis may have a painful substernal sensation when swallowing hot or cold food, acid or carbonated beverages, etc. Odynophagia may be very pronounced in patients with viral (herpetic) esophagitis, monilial esophagitis or Crohn's disease of the esophagus.

Odynophagia may also occur in patients with an apparently normally looking esophagus as described by Edwards in the tender esophagus syndrome [1].

In patients with noncardiac chest pain, edrophonium provocation of esophageal motility may induce chest pain in relation to swallowing [2-4].

By definition, Odynophagia occurs in a strict temporal relation to swallowing and can therefore readily be ascribed to the esophagus. Odynophagia, therefore, does not pose an important diagnostic problem in patients with noncardiac chest pain.

References

1. Edwards DW (1974) History and symptoms of esophageal disease. In : Diseases of the Esophagus, G Vantrappen and J Hellemans (eds). New York, Springer Verlag pp 103-118.

2. London RL, Ouyang A, Snape WJ Jr, Goldberg S, Hirschfeld JW Jr, Cohen S (1981) Provocation of esophageal pain by ergonovine or edrophonium. Gastroenterology 81 : 10-14.

3. Benjamin SB, Richter JE, Cordova CM, Knuff TE, Castell DO (1983) Prospective manometric evaluation with pharmacologic provocation of patients with suspected esophageal motility dysfunction. Gastroenterology 84: 893-901.

4. Lee CA, Reynolds JC, Ouyang A, Baker L, Cohen S (1984) Esophageal chest pain : diagnostic value of high-dose Tensilon provocative testing (abstr.). Gastroenterology 86 : 1156.


Publication date: May 1991 OESO©2011